Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Revita Life

Q: What type of organization is Revita Life?

Revita Life is registered in NPPES as a Dietary Manager (its primary provider taxonomy).

Dietary Manager in Detroit, MI · enumerated 2006 · authorized official Andre Nunn, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1225139439

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Registry record

Entity type Organization (Type 2)

Legal business name Revita Life

Practice address 4106 John R, Suite 805, Detroit, MI, 48201

Phone (313) 745-7454

Fax (313) 993-8625

Enumeration date Sep 26, 2006

Last updated in NPPES Aug 22, 2020

Taxonomy & classification

132700000X Dietary Manager Dietary & Nutritional Service Providers · License AN066667 (MI) Primary

Authorized official

Name Andre Nunn

Title President

Phone (313) 745-7454

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What type of organization is Revita Life?

Revita Life is registered in NPPES as a Dietary Manager (its primary provider taxonomy).

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.